Provider Information for 1356434799
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PHARMACY SERVICES OF CAMPBELLSVILLE
Other Names:Doing Business As:THE MEDICINE CENTRE PHARMACYOrganization Subpart: NO
NPI: 1356434799
Last Updated: 2015-11-10
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1356434799 | ||||||||||||
| Enumeration Date | 2006-09-30 | ||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||
| Status | Active | ||||||||||||
| Authorized Official Information | Name: EDWARD BAISE PBS Title: PHARMACIST AND OWNER Phone: 2704653784 | ||||||||||||
| Mailing Address | 325 E BROADWAY ST CAMPBELLSVILLE, KY 42718-2003 United States Phone: 270-465-3784 | Fax:270-789-3784 | ||||||||||||
| Primary Practice Address | 325 E BROADWAY ST CAMPBELLSVILLE, KY 42718-2003 United States Phone: 270-465-3784 | Fax:270-789-3784 | ||||||||||||
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